Insurers are employing different strategies to manage the high cost of GLP-1 drugs.
In May, CVS Health announced a partnership with Wegovy manufacturer Novo Nordisk. CVS Caremark will use Wegovy as the preferred GLP-1 medication for its largest commercial formulary. Beginning July 1, CVS Caremark will drop Zepbound, manufactured by competitor Eli Lilly, CNBC reported.
The main pain point among CVS Caremark’s client base has shifted from specialty drugs to GLP-1 drugs, Prem Shah, PharmD, executive vice president and group president, CVS Health, told investors. Around one-third of the company’s clients choose not to cover GLP-1 drugs for weight loss, Dr. Shah said, and lowering costs could expand access.
“We’re continuing to drive the market to make medications more affordable, drive long-term value for our clients and create competition with pharma,” Dr. Shah said.
CVS is also the first retail pharmacy partnering with NovoCare, Novo Nordisk’s direct-to-consumer platform for GLP-1s. Humana’s CenterWell also struck a partnership to manage prescription fulfillment and delivery for NovoCare.
Cigna also announced new efforts around GLP-1 costs in May, taking a different approach from CVS. The Cigna Group will add two new programs, one designed to support pharmacies dispensing the drugs, and a home delivery program.
In 2024, Cigna launched EncircleRx, a program that controls the cost of GLP-1 medications for employers. The program has grown to 9 million enrollees in a year.
Brian Evanko, Cigna Group President and COO, told investors on a May 2 call that he does not see formulary changes or preferring one manufacturer’s GLP-1 over another as “sufficient to generate the societal impact these drugs can have.”
“We’re really proud of our comprehensive approach to the GLP-1 market and the solutions that we’ve introduced that address access, affordability, clinical safety and longer-term lifestyle changes,” Mr. Evanko said.
Most GLP-1 drugs are approved to treat type 2 diabetes. Wegovy and Zepbound are approved for weight loss. The drugs often cost more than $1,000 a month.
Multiple insurers have cited the high price of GLP-1 drugs as a contributing factor to financial losses in 2024. Some insurers have chosen to drop coverage of the drugs for weight loss altogether.
